by Tim Parks
THE NIGHTS WERE unpredictable; I was growing used to that. My wife and I slept in the same bed, but more apart than before. Discomfort formed a shell around me. My wife was careful not to enquire too much, or she was growing bored. She was walking the dog later. I was going to sleep earlier, after a whisky, of course. Then the counting began. How many bathroom trips? At what intervals? Sometimes I thought I should write them down. Perhaps I would see a pattern in the numbers. But what could the pattern tell me that I didn’t already know?
Basically, each night divided itself into segments: two or three of one and a half hours, followed by two or three of one hour. These must be the famous sleep cycles. Sometimes, but more and more rarely, I would skip one of the breaks and not wake for a whole three hours. Opening my eyes, then, I was intensely and pleasurably aware that I had slept for longer than usual.
On the bedside table was a digital clock that lit up when you tapped it. It glowed dimly and emitted a faint electronic whine. Waking, I would feel pleased that I knew what time it was even before checking, as if this little achievement cancelled out the defeat of needing to wake so often.
Wearing just a T-shirt, I shivered barefoot down the stone stairs. Only the dog would see me. A Border collie. His basket almost blocks the bathroom door. Invariably, he opens an eye as I step over him. What did he think, I wondered, about me getting up so often, leaning on the wall over the loo to pee?
Then there was the question of whether to flush. Six times three hundred and sixty-five would be two thousand one hundred and ninety flushes in a year. That’s a lot of water in a country with over-stretched resources. I let the bowl stew till around five. No one would be using the bathroom before six.
You’re becoming a creature of the night, I thought, climbing the stairs again. You and the dog. Sometimes, I rather liked this feeling of making the small hours present, being around when no one else was. My mental life was changing. In bed, I could lie and think about what I was writing. I had learned not to worry about sleep; it always came. Thoughts were richer and more bizarre in the night, rarely useful if remembered in the morning, but more pleasurable. Almost a sensual pleasure. Rousseau was constantly pushing catheters into his penis, I remembered. To pass his stones. He writes about it in the Confessions. At one point he bought a lifetime’s supply of catheters. At least I had been spared that. Montaigne also suffered from stones. Was it something to do with writing in French?
In the second half of the night the dreams came. I dreamed my wife and I were walking through Verona by the river, but the water had dried up, there was only a muddy trickle, and the solid bourgeois palazzi along each bank turned out to be built on wooden stilts rotting in the sludge.
At five the pain woke me. It was ferocious. I went downstairs, peed again, flushed the smell away, ate my cereal, and once again got on the net to look up cellule uroteliali and strutture papillari, nucleo ipercromico. I had taken urine samples to the hospital three days running. They had centrifuged the samples and carried out a cytological analysis. There were precancerous anomalies.
‘Could be anything or nothing,’ the lady doing the ultrasound scan said. ‘Let’s see what we can see.’
I was paying privately now. This dottoressa was the only person in Milan whose scans he and his colleagues trusted, Carlo had told me. She slid the scanner slowly across Vaseline on my stomach and I asked her if she saw a lot of cases like mine.
‘Sure, lots of guys your age. It’s standard stuff.’
She was in her mid fifties, grey-haired, a small pouty mouth, pretty.
I asked her if she noticed similarities between the men she saw with these symptoms. She worked while we talked. Her right hand moved the instrument back and forth across my belly in sweeps, some fast, some slow, halting a moment, then off again, searching, intent; her eyes were focused away from me on a computer screen. The left hand tapped on a keyboard. She was concentrating. I could just glimpse phantom shapes in a dark turbulence on the screen.
‘Well, they are all busy people,’ she said. ‘It’s always difficult to make appointments. Now, if you could go and pass water, please.’
I went to the bathroom, peed and came back. She was clicking through images on the screen, making notes.
‘That was quick,’ she observed.
‘Quick?’
‘Too quick. Go back and finish. I have to measure how well the bladder voids. It won’t be empty yet.’
I had peed my normal pee with no impression at all of having hurried. Obedient but sceptical, I went back to the loo and found that, though I had no impulse, there was still a fair bit to go. Weird. She knew my body better than I did.
‘Thirteen ccs,’ she said. That’s how much was in there now. ‘It’s nothing. You void fine.’
I was foolishly pleased, but then vaguely wondered if she hadn’t been cheating sending me back again. Did that mean I could always pee more when I thought I’d finished? I also wondered if she would be candid with me if a tumour appeared on her screen. In a kidney perhaps. But I wasn’t going to put her on the spot by asking. It would all be in the results.
I waited while she pressed the scanner lower down my belly, then thought, why not put her on the spot? Why this heavy silence around illness? I was paying. It was my body.
‘So where are the tumours?’
She smiled. ‘Hiding so far.’ She understood my mood exactly. ‘If there is something, it’s probably in the bladder wall. You’ll need a cystoscopy to see that.’
I had to turn on my side and pull my underwear down. She switched instruments for the anal scan. It’s strange how we let these things be done to us, casually, as if they happened every day. I tensed.
‘Relax.’ She pushed the thing in.
‘The doctors think I need the TURP,’ I said.
I stared at a glass cabinet full of small white boxes. The word TURP, I thought, seemed to give the operation an acrid turpentine smell. She said nothing. I was sent to the bathroom to wipe off the Vaseline. When I came back she was sectioning shadows on the screen and measuring them. If I would wait five minutes outside, she said, she would type out her report. I could then take it to my doctor for his assessment.
‘Just tell me straight,’ I asked. ‘I won’t understand the medical stuff.’
She frowned at the screen. ‘The prostate isn’t enlarged at all, actually it’s rather small for a man of your age. All I can see is some faint calcification. Within the norm.’
Not enlarged! It must be cancer then, I thought. In the bladder wall. That was the rock in my belly, the constant, nagging pain. All the same, I was oddly pleased that the ‘official medical version’ had been proved wrong.
I called Carlo. ‘Afraid not!’ he laughed. ‘The prostate can be small, but fibrous inside round the urethra. It’s complicated. We have to wait till all the tests are done. Then I’ll send you to the best surgeon.’
About a week later, I had a disquieting experience in a restaurant. A university colleague and I had invited a visiting professor to dinner. We had been sitting together talking about translation, the subject I teach. The visitor was American, a real academic with a penchant for Walter Benjamin and Derrida. He grew earnest, insisting on what he saw as a deterritorialisation of the signifier despite the essential stability of the signified in a shifting translingual pattern of différance, doing his best to emphasise the anomalous ‘a’. Edoardo and I encouraged him to eat ossobuco, the local speciality, and he did, but without interrupting his description of the various projects he had in hand. He was balding, bulky and intensely solemn, to the point that I began to wonder whether he had noticed what was on his plate at all. He ate with embarrassing, almost infantile appetite, but his mind was entirely taken with himself and his différance. Edoardo, who is slim and elegant, smiled politely, occasionally trying to change the subject. I stood up and announced I had to go to the bathroom.
Since the experience with the ultrasound doctor, I had been trying to slow down my peeing, waiting a w
hile after finishing to see if there was more. Naturally, my hope was that this little encore would reduce the number of times I had to go. It didn’t. Apparently there was no relation between the quantity I needed to pee and the impulse to go. So what difference would it make, I wondered, if they ‘cored me from the inside’, and I ‘emptied better’, as Carlo had put it? I walked through this rather quaint Milanese osteria, found the bathroom, turned on the light, went in and locked the door. The pee was slow in coming. When I’d finished I waited a little more and . . .
The light went out.
It must be on a time switch. I was in the dark. There wasn’t so much as a chink. And the switch, I now recalled, was on the outside. Obviously they didn’t want people hanging around in the loo, shooting up, masturbating, making love. But had I really taken so long? I zipped up, turned, and found I couldn’t locate the door. I banged into a washbasin. The corridor light must be off too. There was no window, just a vent humming, sounds of dishes and footsteps, but distant. It was pitch black. Talk about deterritorialisation. I reached out to feel the wall and, as my hands met first a tiled surface, then plaster, then a pipe, I felt intensely present, intensely aware of being alive, here, right now, in this idiotic situation, stuck in the loo in the dark.
I still couldn’t find the door. Would I have to yell? How foolish I would seem!
Then I had the door, but couldn’t find the lock. What kind of lock? I couldn’t remember. A latch? I started to feel panicky, as when you go upside down in your kayak in a rapid and you can’t roll up and then can’t find the tab to pull your spray deck and escape. You only have so long. The length of this breath.
Got it. I’d been looking on the left of the door instead of the right. There was a small button that turned inside a knob. I pulled the door open and at once was immersed in normality. Food smells, laughter, warm air, photos of Milan in the ’30s. How wonderful. Forget hand-washing, though. I hurried past a full-breasted woman leaning across a table. A waiter winked. It was so convivial! Just as I sat down the American pronounced with great indignation: ‘People really don’t want to accept that the language they live in is only one of many possible worlds.’ He hadn’t noticed I’d been away too long. Edoardo was nodding. I poured myself a glass of wine and drained it in a gulp. This is what it will be like, I thought, if I ever return from illness. Nobody will have noticed I was ever away.
Remember Life?
‘SIGNOR PAX, COULD you just tell us whether you need to pass water or not?’
There was a note of exasperation in the young doctor’s voice.
What struck me, on my back under a huge grey X-ray machine, was the distance between the medical staff and myself; however sophisticated their equipment, they were a million miles away from the stewing confusion in the organs they were photographing, the mesh of unease inside my head. Perhaps they were a million miles away because of the equipment.
‘Signor Pax . . .’
‘No, I can’t tell you,’ I snapped. ‘And if I could, I wouldn’t be here.’
One of the pretty nurses almost giggled and had to turn away with her hand over her mouth. Or maybe she’d just had enough of looking at my nether parts.
The urogram is one of those medical tests of which one says, if you’re not feeling ill before, you will be afterwards. But I was feeling ill before. The previous week, on a promotional trip to Germany, I had barely been able to sit through the evening presentations. The pain was hot, fierce, constant. I needed to walk. I couldn’t concentrate on the public’s questions. I simply had to move. Released, I hurried outside to find a freezing wind and slushy snow that swamped my shoes. Frankfurt was cold and gritty and full of building sites. And I felt worse. For the first time walking was as painful as sitting. You’re a zombie, I told myself. The only thing to do was to finish these tests and let the doctors operate.
Do it. Get it over with.
The urogram is a series of X-rays of the abdominal area. After the first pictures of your belly as it ordinarily is, they fill you with a radioactive contrast medium by intravenous drip so that the X-rays can record the liquid’s passage through kidneys, bladder and urethra. The day before the test you have to take a laxative, then eat nothing afterwards. The intestine must be empty.
This punitive preparation guarantees you arrive stressed. While Rita and the girls were eating roast chicken the evening before, I was sitting in front of an oily, lemony-tasting electrolyte. Two litres of it. An hour earlier, the first mouthful had seemed almost pleasant but after a pint or so the stuff grew sickly, heavy. It was physically hard to force it down.
Retiring to the bathroom, still with a full jug of laxative to get through, I took the cordless with me. I phoned Carlo to thank him for making the appointment at the hospital. He wouldn’t be around personally, he said, but he would arrange for the hospital’s best surgeon to meet me afterwards to look over the results together. ‘Actually the best surgeon in Italy,’ he added. ‘Bar myself of course!’
In my bowels something dissolved.
On impulse, why?, I phoned Mum in London. She was in a cheerful mood despite her breast cancer which we didn’t mention. Your mum is much worse off than you are, I thought. People all over the world were far worse off.
The door handle rattled as one of my daughters tried to burst in. I covered the mouthpiece to yell out my presence.
‘Nothing serious, love?’ Mum asked jollily.
‘I was thinking about Dad.’
There was a silence.
‘I just wondered if he ever had problems, with needing to go to the bathroom a lot at night.’
‘Oh.’
Mum thought about it in her tiny London terraced house, a sort of bed-sit on two floors.
‘He did go to the toilet a lot when he was nervous.’ She added, ‘Like all men, I suppose. Is there anything the matter, love?’
Tectonic plates shifted in my fundament.
I told Mum it was probably just a phase. Why on earth had I chosen to call her at this of all moments? I hung up and spent a truly unpleasant hour emptying my gut. Laxatives are unnatural, I decided. Passing water through your anus is extremely unnatural.
Towards nine, when it was all done and I’d cleaned up, I went downstairs and Googled ‘urograms’ to find out exactly what was in store for me at the hospital. Almost at once I turned up a research study claiming that ‘laxative preparation does not improve imaging during intravenous urography. Radiology departments still requiring laxative administration prior to the urogram are not practising evidence-based medicine.’
It was not encouraging.
Around eleven the following morning, I lay down on a thin mattress beneath a monster of an X-ray machine while a nurse set up a drip with the iodine contrast medium, then strapped a thick belt over me. She pulled it tight. Then tighter.
‘To keep the fluid concentrated in your kidneys while we X-ray, we have to compress the lower abdomen.’
‘It has to hurt, I’m afraid,’ an older doctor chipped in.
‘It’s doing its job,’ I assured him.
The photo shoot began. Every time they took an X-ray, all four staff scurried to a door behind me and watched through a glass screen. X-rays are dangerous of course. After half an hour, the belt was released and I was sent off to walk around, ‘until you’re ready to pass water, Signor Pax’.
The problem was the word ‘ready’. I was already dying to go. There was a festering heat down there that might erupt at any moment. After ten minutes I hurried back only to be told that I couldn’t possibly be ‘ready’ yet. Anyway, they had another patient.
‘You won’t be ready for at least an hour,’ the assistant doctor said rather sternly, over-pronouncing as a concession to my foreignness.
All the same I felt desperate to go.
‘Walk around,’ they said. ‘Relax.’
The imperative ‘relax’, like the over-pronunciation for foreigners, is something that drives me crazy.
I walked. The hosp
ital has a main block and two wings, each with dauntingly long corridors. The walls are a light grey, the floors, blue linoleum, the lighting an insomniac fluorescence. Hospital staff hurry by in white coats, green trousers, clogs. Less sure of themselves, patients and visitors stare at signs: Oncology, 5th floor, west wing; Cardiology, 2nd floor, main block. The body is divided up into floors and wings. The vital organs are kept well apart. People lose their way in between, clutching large yellow envelopes with technical information about their innards, much as they might clutch VAT returns and invoices at the tax office. All in all there is little to distinguish the place from other government buildings. It’s not a house of reassurance or healing; not if by healing we mean wholeness. It’s a grand industrial and bureaucratic enterprise. You come here to get your body serviced, to have bits removed, prostheses installed, medicines administered, in the separate and appropriate parts of the building. How could it be otherwise? There’s a queue at the window for making appointments, another queue for collecting results, another queue for paying. Here and there, rows of chairs have been bolted to the floor. A young man is sitting with his head in his hands.
They had told me I could have a coffee, so I went to the cafeteria. The big window panes were steamy against the cool air outside. It was overcrowded but friendly. I sat down, found it too painful and drank standing at the counter, watching MTV. The volume was so low you could hardly hear the beat that three girls were moving to. Their gestures were elaborately erotic, their clothes spectacularly impractical. I gazed, amused and perplexed. The girls gyrated and shook. The body has become a parody of the body, I thought. This dance was a spoof of sexual allure. All around me people’s postures were neutralised, resigned, mechanical. On screen, the girls rehearsed a pantomime of exaggerated vitality. For money. They didn’t care whether we believed in it. Remember life? their young hips said, Remember sex? What a joke!
To while away the rest of the hour I walked in the gardens, so called. A gravel path made aimless twists and turns between winter shrubs dwarfed by walls of illuminated windows. The benches were empty. The only other visitors advanced no further than the first frosty flowerbed. They had come out to smoke. The soil was littered with stubs. The vegetation was grey. This garden is no more than a reminder of gardens, I decided, just as the music video had been a harmless reminder of eroticism. The present is cytology, radiography, ultrasound, cigarettes, anxiety.